Impact of Adjuvant Anticonvulsant Medications on Benzodiazepine Use and Delirium in Alcohol Withdrawal Syndrome.

Abstract

Objective: To assess the benefits of anticonvulsant medications on benzodiazepine (BZD) use and delirium in patients with alcohol dependence at risk of alcohol withdrawal and admitted to the hospital without delirium.Methods: This was a resident-led retrospective study of prospectively collected data for patients admitted to the monitored unit of a general medical ward between June 2016 and March 2017 for a variety of medical conditions. Patients were assigned to the usual care group (BZD as needed) or the intervention group (scheduled anticonvulsants and BZD as needed) based on admission census and order of arrival. Of 75 patients, 44 were assigned to the usual care group and 31 to the intervention group.Results: Significantly lower BZD dosage (P = .0002) and lower Clinical Institute Withdrawal Assessment for Alcohol Scale-Revised scores were observed in the intervention group. Delirium occurred significantly less in the intervention group (0 versus 7 in the usual care group; P = .037).Conclusions: Adjuvant anticonvulsant medications for alcohol withdrawal were efficacious in reducing BZD use, severity of symptoms of alcohol withdrawal, and occurrence of delirium in patients admitted to the general medical ward without delirium for reasons other than alcohol detoxification.